SleevePerry

I was approved! Surgery is 6/9!

I was approved!!!!! Surgery is June 9th!

Good luck!!

We submitted to Aetna on Friday. This is going to be the longest week of my life. No doubt. I'm a 41 BMI this year but was a 38 or a 39 BMI for the preceding 2 years (I was dieting. Always dieting). I'm so hoping that my constantly working to keep the pounds away doesn't come back to bite me in the behind. Fingers crossed and lighting candles. Gah.

@@tafuller What was your starting BMI? Did you have two years of weigh-ins, and were they over 40 BMI?

Have you already submitted @@majorsmama? They probably do want two years of a 40 BMI, and it probably will be an issue if I don't have it but, per the Aetna Bariatric nurse I spoke with, it's not necessarily a deal breaker. I guess I'll know soon enough, as we'll be submitting for approval toward the end of the month.

I had a guy friend who was internet dating. He went out with a woman who, on their second date, told him that she had been on the television show, The Biggest Loser. She came over to his house for their third date to watch a movie (wink wink) and he blew it by getting blackout drunk and falling asleep while they were making out. He explained that he did this intentionally, that he didn't want to get naked with a former fatty with saggy skin. I never spoke to him again.

I spoke with Bariatric RN at Aetna regarding my VSG Approval concerns. I just feel like I'm going to get denied, and I can't allow that to happen. I have a BMI of 41, but had a 38 BMI the previous two years. The RN said I wouldn't be denied outright for this, but that it would go to to the Big Boss for review. I am getting a letter from my PCP, stating that I have been attempting weight loss and management for 10 years. I'm also including this letter. Thoughts? To whom it may concern: My name is XXXXX. I am 43 years old and have been obese since early childhood. At age 13, I weighed 200 pounds. At age 17, I weighed 225 pounds. At age 23, I weighed 245 pounds. At age 33, I weighed 215 pounds. At age 42, I weighed 232 pounds. In the last 10 years, I have fluctuated between 200 and 255 pounds. Regardless of how much or how hard I exercise, no matter how strict my diet, I cannot seem to get down to a healthy weight and to maintain that weight. I am writing this letter to ask for your help. I have been consistently dieting and exercising all of my life. I spent 3 years on the Atkins plan, faithfully eating less than 20g of carbohydrates per day, which allowed me to maintain an average weight of approximately 200-215 pounds. I spent 6 months on Nutrisystem, which resulted in a 5 pound weight loss. This past year, I paid $130/week for 12 weeks of 1,200 calorie per day meals from Diet2Go and, from that, lost one pound. I was exercising a good amount during all of these weight loss attempts, and I still continue to move each and every day. I don’t give up. But it seems that, no matter what effort I make, the number on the scale continues to rise and, the older I get, the more difficult it is to stop that number from its seemingly steady incline. I have been on a high-Protein, low calorie diet for the last four months, and I have been recording my diet and exercise and meeting with a nutritionist, who seems to agree that I am doing a good job of staying on plan. 10 weeks ago, I ended a pack a day, 30-year smoking habit and, while I haven’t managed to lose a substantial amount of weight during this quitting process, I have not gained a single pound. Of this, I am proud. At 43 years old, I weigh 251 pounds. My BMI is over 41. My body is straining to support this extra weight, and I am greatly feeling the effects of this strain. I am experiencing pain in my knees, in my back, in my feet. Despite remaining physically active, something as minor as climbing two flights of stairs leaves me winded, sweating profusely and with an alarmingly-rapid heartbeat. Without medical intervention, I fear that these existing maladies will only deteriorate with the coming years, and that more ailments will soon join them. Should my condition continue to deteriorate, I fear that I will require a succession of reactive surgeries. I have an immediate family history of Diabetes, of Heart Disease, of Heart Attack, of High Cholesterol, of Hypertension and of Cancer. I know that my weight and my propensity to hold the majority of this weight in my midsection increases my risk of Heart Disease, Cervical Cancer and Diabetes and, as a morbidly obese person, this is of great concern to me. I recognize that weight loss surgery is not an answer, but a tool. I feel that I’m well-prepared, dedicated and disciplined enough to effectively use that tool and to become a Weight Loss Success Story. I hope very much that you’ll give me this chance to do so. Best regards,

I'm 43 now and I had a recorded 40 BMI at age 23. I've gone up and down for 20 years, but the scale is winning, as it's getting harder and harder to keep weight off as I get older.

I have a weight history for two years, just not a 40 BMI. I'm always dieting, and have needed to do so to maintain a 38 BMI. No co-morbidities as of yet, but a family history of diabetes and heart disease. I also spoke to a weight guru there and she said a 40 BMI for 2 years wasn't specifically required, that they look at a multitude of things. So frustrating, not knowing if you are doing all of this for nothing.

From what I understand, the Aetna site used to indicate that 2 consecutive years of a 40 BMI was required. They now just state that a history of severe obesity is required. But that's pretty vague so I'm hoping someone on this site has recently dealt with Aetna and has a history similar to mine...

Hi everyone! I'm in the home stretch of the VSG pre-approval process and the worry that Aetna will deny me has started to creep in. I'm getting a bit panicky! I started the process with a 41 BMI. No co-morbidities. My 2013 and 2014 BMI was 38 (I was on Diet2Go in 2014 and Nutrisystem in 2013). I've provided the surgical coordinator with BMI records for 2013 and 2014, but she doesn't believe they are needed. I'm not so sure. More so, I'm worried that not having a 40 BMI in 2014 and 2013 will cost me surgical approval. Has anyone had experience with Aetna in 2015? Whatever experience you can share would be helpful. Thanks in advance!

I'm on Instagram, and really enjoying meeting other folks who have had or are having surgery. My user name is Shrinking.Violet_

Thanks so much for all of the replies. This was truly helpful. I'm going to take 2 weeks, and have let my employer know that I may need to work half days during week 3. I think this will appease my doctor. Honestly, with our having a Water cooler steps away from my desk, I feel like it'll be fairly easy to keep pushing the fluids, and I'm more apt to walk a little bit more if I'm at work, as opposed to if I were lying in bed or on the sofa.

My surgeon has advised that I take 4 weeks off work after having the sleeve. I asked her if 2 weeks would be enough and she told me it was not. My company only allows for 2 weeks of sick leave. These dates cannot be carried over from year to year, so I'm stuck with just 2 weeks of recuperation. I live a 10 minute drive from the office, sit at a desk all day, and my office has a fully stocked kitchen and a wellness room with a sofa. Oh, and my mom is at my office with me I could also probably leave early during week 3, if need be. Do you think this will be sufficient? How long were you out after having the procedure? I see that some folks have taken only a few days, and others 6 weeks. I'm trying to gauge how I would fair. I'm 43, in decent shape (apart from the weight), no co-morbidities, basically in good health. Thanks in advance!

I have Aetna and my out-of-pocket is $500 deductible + 20% of costs, up to $2000. The most I'll have to pay is $2000, which doesn't seem bad, although I wouldn't mind just a $250 copay. The surgeon's office is also charging a $350 administrative fee that is not covered by insurance.